1983, 08-12 Permit: 83A-7730 Wood StovePLAN NUMBER
APPLICATION/PERMIT
SPOKANE COUNTY - DEPARTMENT OF BUILDING & SAFETY
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
STREET ADDRESS
1. S 2:-S
LOT BLOCK SUBDIVISION
2.
PARCEL NO.
OWNER
G'ANt.,svrfly
PHONE
PHONE
4,_7-(C
LEGAL DESCRIPTION:
MAILING ADDRESS
6011Pt4ra S "f -"c. 7.c.Bc•
4.
CONTRACTOR
LICENSE EXPIRES
ADDRESS
DESIGNER
5.
ADDRESS
CHANGE OF USE FROM
6.
ZIP
QCT 2
PHONE
ZIP
PHONE
ZIP
TO
TYPE ANEW ❑ ALT. ❑ AD' N. 0 RPL. ❑ MVE.
7. OF WORK 0 BLD. 0 PLMB. C�1AECH. 0 M.H. 0 POOL LI OTHER
Actual Set Backs in Feet to:
North (South [East West
Size of Parcel
Zone Classification
Type Const. Occupancy
New Const. Valuation
Residential (1
Commercial E
Sprinklered
LYes ❑No ❑Req'd.
Remode ed Valuation
Main Floor Upper Floors
Cover Deck
No. Baths
CertifI. of Exempt.
or Variance
Uncv. Deck
Total Bldg. Floor Area
Garage/Storage I Greenhouse
No. Floors
DESCRIBE WORK
8. 2ca. U s—,
" .
VALUATION
9.
SOURCE
F
UTILITIES
GAS
ELECTRIC
WATER
PUBLIC ❑
PRIVATE ❑
SEWAGE
SEPTIC 0
SEWER 0
Fin. Basement
No. Fin. Rooms
Required Yes❑ No❑
Received Yes C' No f -
Shorelines/Flood Hazard
Yes Not Apollo. El
Ownership
Public 0 Private 0
I hereby certify that I have read and examined this application and have read the "NOTICE" provisions included on
reverse side, and know the same to be true and correct. All provisions of laws and ordinances governing thls type of
work will be compiled with whether specified herein or not. The granting of a permit does not presume to give au-
thority to violate or cancel the provisions of any other state or local law regulating construction or the performance
of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTIONS
SIGNATURE OF APPLICATION
OWNER OR AGENT DATE
SPECIAL APPROVALS
PRELIM. FINAL DATE
Env. Health
Planning
Fire
Prevent.
Engineer
UtIllties
SEPA
Plans
Exam.
Building
Tech.
SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
PERMIT IS NONTRANSFERABLE
PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
IN 180 DAYS
Unfin. Basement
No. Dwellings
Number
Plans Required C1
Received E
FEES COLLECTED
Building
Plumbing
Mech.
Plan Check
SEPA
Modular/
MFG. Home
Other (Specify)
cel
TOTAL $ z,.
PERMIT NUMBER
04* *2000
*20.006
A *0.00 8
77292
08-12-83
2 6479.
W
LL
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
DATEQSSUE2 - Dl 0 t
PERMIT/NO. 3' 0 z
*20.00�4AL